The invention relates to an apparatus and a process in order to begin a locomotion training of patients with walking impediments in an early phase of rehabilitation.
In incompletely paraplegic patients the possibility has been shown to exist of improving walking ability up to normality by means of an adequate locomotion training. The required therapy at present takes place on a moving belt, where walking is first made possible for the patient by defined weight relief and partially by additional assisting guidance of the legs by physiotherapists (Wickelgren, I. Teaching the spinal cord to walk. Science, 1998, 279, 319-321). This kind of locomotion therapy can of course only be started when there is sufficient stability of the circulation, since the patient has to remain for a long time in an upright position. The required circulatory stability is as a rule not present in the first weeks after the onset of the spinal cord lesion.
In the rehabilitation of patients with limited motion of the legs or after orthopedic operations, various driven ortheses are already in use which actively move the legs of recumbent patients.
U.S. Pat. No. 5,239,987 (1993) describes such a system. In this apparatus, the legs are guided primarily in that the lower leg is moved relative to the thigh. However, no apparatus exists in which a knee extension with weight loading on the sole of the foot is attained in the extended phase (xe2x80x9cstanding phasexe2x80x9d) of the movement cycle. Hip joint extension is also not present in the said mechanisms.
U.S. Pat. No. 4,986,261 (1991) describes an apparatus which also effects a hip joint extension. However, the knee joint is not moved there as in physiological walking.
None of the described systems make it possible to move the legs while the inclination of the patient can be simultaneously adjusted.
The present invention has as its object to make possible an intensive walking training (activation of the motion centers in the spinal cord) of paraparetic and hemiparetic patients, before they are physically able to take part in a moving belt training, that is, in a still unstable circulatory situation. The possibility is to be provided of steadily bringing the patient""s body closer to the vertical position. The aim of the apparatus according to the invention is to provide a so-called xe2x80x9cactive standing tablexe2x80x9d (tilting table) which makes possible the movement of the legs of paraplegic patients in a manner physiologically similar to walking, without the necessity of having them stand upright.
This object is attained according to the invention with an active standing table according to the wording of patent claim 1, and an associated process for the operation of the active standing table according to the wording of patent claim 8.